Baylor Scott & White’s accountable care organization created $39.3 million in savings last year for the federal government’s Medicare Shared Savings Program, the highest total among participating Texas hospitals.
Baylor Scott & White’s results also placed the health system seventh nationally, earning it $18.7 million in shared savings, according to results released this week by the Centers for Medicare & Medicaid Services.
It’s is one of 548 total MSSP participants in the country working to provide higher-quality care at a lower cost through accountable care organizations. Participants that demonstrate improved health care conditions are rewarded with a share of the savings. Nationally, ACOs saved Medicare $1.7 billion last year.
“Baylor Scott White Quality Alliance is really a huge investment … to change the way health care is delivered and make it more affordable and better for the communities that we serve,” said Jenny Reed, vice president of comprehensive care management at Baylor Scott & White.
ACOs like Baylor Scott & White Quality Alliance were created as an alternative payment model with the intention of improving quality and cost accountability for patients using Medicare. ACOs are an umbrella of physicians and hospitals, which work with health insurers to lower health care costs.
“We’re not taking our foot off the gas,” Reed said.
Baylor Scott & White credits its improvements in 2018 to comprehensive care management, use of data analytics and physician engagement.
Last year, the ACO was able to implement resources it hadn’t in previous years like additional staffing, which included nurses, community health workers and social workers. And it plans to add even more this year, said Clifford Fullerton, president of the quality alliance.
Baylor Scott & White reported improvements in hospital readmissions, avoidable hospital admissions, and Medicare annual wellness visits in 2018. Hospital readmissions fell from 12.55% in 2017 to 12.36% in 2018, according to the ACO. Avoidable hospital admissions per 1,000 beneficiaries also decreased by 9.2% in 2018.
Rather than letting a person who has a chronic illness go to the emergency room for unplanned care, the ACO works with physicians to improve care and efficiency through phone calls or office visits, ideally preventing conditions from worsening to the point of an ER visit, Reed said.
With about 125,000 beneficiaries, Baylor Scott & White’s program saved an estimated $314 per beneficiary in 2018.
Early studies have shown varying degrees of success from the Medicare savings program in its relatively short existence. Baylor Scott & White said its continued improvement is a demonstration that the model can change the way health care is structured for the better.
“I think we’re beginning to see the proof that it can work and start to drive down costs without just creating some sort of a draconian way of avoiding care,” Fullerton said.
Baylor Scott & White is Texas’ largest nonprofit health system, with 50 hospitals.